Candidate: Vijaya K. Hogan, Dr. P.H., M.P.H. is a Clinical Associate Professor in Maternal and Child Health and Adjunct Assistant Professor in Ob/GYN at the University of N. Carolina. Her research focuses on causes of preterm birth and ethnic disparities. Career Development Plan: The candidate will participate in formal coursework, workshops and mentored research to learn essential theory, knowledge and skills and social science methods relating to determinants of health, in advanced quantitative analytic techniques and in ethical conduct of research. Immediate Objective: to integrate social science and epidemiologic methods to understand effects of social exposures on vulnerable populations. Long-term objective: To reduce national rates of preterm birth and disparities by developing and applying this integrated knowledge to the design, implementation and evaluation of effective multi-level (behavioral, social and clinical) randomized controlled interventions. Specific Aims: 1 .Identify and validate specific social factors that adversely impact on women's participation in preconceptionally delivered preterm birth prevention interventions; 2. Estimate the extent that differential experience of these key factors explains variation in receipt of structured, preconceptionally delivered interventions. Research Methods: Using data and following up on subjects from an existing behavioral/clinical RCT on preconceptionally delivered preterm birth reduction interventions, we will conduct a quantitative analysis using the Anderson Behavioral Model to identify the determinants that explain utilization of preconceptional care in this population. We will then use ethnographic techniques to identify more specific pathways between the social exposures, individual behaviors and access to preconceptional care. Mentorship: Mentorship will be provided by a prominent sociologist (Mullan-Harris); with support from an Advisory group that includes anthropologist, sociologist, demographer, and epidemiologist. Relevance: This research will identify the specific social exposures that continue to exert an influence on health care participation and outcomes, even when all systemic barriers to care are removed. We will develop a replicable and empirical method for measuring the variation in relevant chronic stressful exposures uniquely experienced by African American women with a better understanding of the mechanisms through which these factors influence the effectiveness of evidence-based care. [unreadable] [unreadable] [unreadable]